Lecture 7: Blood Supply to Spinal Cord

Question 1

Describe the three arteries that supply the cerebrum.

Answer 1

anterior cerebral a. (medial cerebrum 70-80%) middle cerebral a. (temporal region) and posterior cerebral (very posterior and inferior cerebrum)

Question 2

Describe the 3 arteries that supply the spinal cord.

Answer 2

one anterior spinal (2/3 anterior part of the spinal cord) artery and 2 posterior spinal arteries (posterior 1/3 of the spinal cord)

Question 3

Describe feeders to the spinal cord below and above T2.

Answer 3

above T2, feeders are off the subclavian arteries (including branches of the vertebral a. at the base of the brainstem, branches of costocervical and thyrocervical trunks in the neck, below, the feeders are segmental a. off the aorta and iliac a.

Question 4

There are spinal arterial branches for each segment of the spinal cord that enters the vertebral foramen via the _____ foramen.

Answer 4

intervertebral

Question 5

If an artery reaches the anterior spinal artery is is called ________ arteries while if they run short or the anterior spinal artery they are called _________ arteries

Answer 5

medullary arteries v. radicular arteries

Question 6

Subclavians give rise to the which 3 arteries?

Answer 6

vertebral a and thryocervical and costocervical trunks

Question 7

The vertebral arteries give rise to which arteries?

Answer 7

posterior spinal and anterior spinal arteries

Question 8

Thyrocervical and costocervical give rise to which artereies

Answer 8

deep and ascending cervical arteries that can become reticular or medullary arteries

Question 9

About how many radiculars make it around to join the anterior or the posterior spinal artery?

Answer 9

around 10 anterior radiculars join the anterior spinal artery, around 12-16 posterior radiculars join and become the medullary to the posterior spinal artery

Question 10

Describe the artery of Adamkiewicz

Answer 10

large version of the medullary artery that supplies the a ¼ the of the spinal cord in 50% of people, it usually enters at T9- T12 to join the anterior spinal artery where it branches into small ascending and large descending branches

Question 11

Explain the idea of a watershed

Answer 11

blood from medullary arteries flow up and down the anterior or posterior spinal arteries but there are regions that dent receive direct blood supply (watershed zones) which are dependent on overlapping vascular fields (T1-4) being the worst

Question 12

Where is the arterial vasocorona?

Answer 12

peripheral artery that runs between the anterior spinal nerve and the posterior spinal nerve

Question 13

Where are the central artery?

Answer 13

branch of the anterior spinal artery, usually only gives branches to one side and supplies central region

Question 14

List the symptoms of a posterior spinal artery infarct?

Answer 14

dorsal columns lost, initial prickly, tingling and falling asleep sensation, eventually loss of ipsi 2 point, conscious proprio, vibration sense below the lesion; dorsal horn at level of lesion is lost so total ipsi anesthesia at level of injury (relatively rare and are usually unilateral)

Question 15

Discuss the symptoms of a anterior spinal artery infarct.

Answer 15

(most common type 70%, mostly bilateral) most typical symptoms include loss of pain/temperature below lesion; initial paralysis then hyperreflexia, LMN in ventral horn die at spinal level, autonomic at or below is initially lost and slowly returns

Question 16

Describe symptoms of a central cord syndrome

Answer 16

LMN in ventral horn, arm but not leg weakness, loss of pain and temp in a restricted area due to pain fibers crossing and symptoms may expand

Question 17

Discuss cord hemisection symptoms (Brown Sequard Syndrome)

Answer 17

paralysis of LMN, UMN ipsi casing spastic paralysis, loss of vibration/proprioception and fine touch), loss of pain and temp not eh opposite side, a few segments below